Response Appreciated

[plzanswr]

Dr.

This summer I came out of a year and  half relationship and became vulnerable.  During the course of the relationship the only thing that took place was receiving oral from my partner.  I did the rapid test in January, February, March & April of this year and all results for HIV were negative. I am a 37 year old gay male.

Mid July -- received a massage from someone on the internet and they performed oral on me and may have swallowed

Late July - started seeing someone who later told me they were HIV positive for the past ten years; they performed oral twice but any ejaculation was by way of j/o.  There was mild foreplay where I can honestly say I was  near their rectal area but never actually inserte

Almost two weeks ago - had an occurence w/ male around 23 from internet.  He performed oral (head/rimming) on me.  I did not perform oral in any of these situations.  During foreplay he slobbed me down with saliva and sat on me.  I was not concerned, because I really didn't think that I would be able to penetrate him with just saliva and no lube.  Unfortunately, not the case.  At the point of discovery,  I removed myself from inside of him.  He wanted me to reenter but I refused and he ejaculated by way of j/o.  After this inicident I thoroughly washed with soap and water.  

Three days later I went to be tested for STD.  They performed culture (swab), urine and blood tests for syphylis, ghonnorea, chlamydia and herpes.  All results - negative.  That same night I had a date with someone who I met off of the same website.  Over dinner they did tell me that they were positive.  When we returned to my house they began performing oral on me while we were watching tv, but I made them stop about 30 seconds into the activity.

Question 1:  Did I test for STD too early?
Questioni 2:  Should I be overly concerned about having been infected with HIV and ultimately, should I be overly concerned with being tested for such?  If so, at what point?

[Edward W Hook, MD]

You have had at least four partners since July with oral sex on all and, on at least one occasion had brief unprotected rectal intercourse with a partner of unknown HIV status.  At last two of your recent partners are known to you to have HIV.  So where do things stand:

1.  No, the timing of testing for gonorrhea and chlamydia was fine.  Syphilis would take, on average, 3 weeks for your test to become positive.  It is rare however.  Herpes -lesions typically appear in a week to 10 days.  Odds are, at this time, you do not have an STD.
2.  If this sort of behavior persists, you should be tested regularly and, at the rate of partner change you mention, probably as often as every six months.  A more important question is, do you really want to put yourself at risk?  While your risk is relatively low for any single expsoure, the facts are, partners met over the net are more likely on a statistical basis to be HIV infected than partners met in other social settings.  Secondly, the risk of oral sex is low but with enough exposures, you can shift those odds.  More exposures, even if they are low risk, can lead to infection if there are enough of them.  As for unprotected rectal sex, the odds of becoming infected are 100 times higher than for oral sex.  I urge you to think long and hard about safe sex.  Why push your luck?

EWH

[plzanswr]

Thank you so much for your feedback and response.  I am extremely appreciative that you took the time.  Due to the fact that I had exceeded my 2,000 character limit, I was unable to indicate that I have definitely come to the full conclusion that these casual occurences are not worth it, regardless of how vulnerable and hurt I might feel as the result of a broken relationship.  Since I do no like being tested, this behavior will not persist.  Naturally, you are absolutely correct, pushing my luck is not the answer!